Summaries of health policy coverage from major news organizations

New York Times Investigates New York’s Homes for Adults with Mental Illnesses

In an investigative series, the New York Times profiles New York's privately-run state-regulated adult homes, which have become "places of misery and neglect, just like the psychiatric institutions before them."Examining 5,000 pages of annual state inspection records, 200 interviews with workers, residents and family members and 36 visits to the homes over a year, the Times found that the "state has not kept track of what could be the greatest indicator of how broken the homes are: how many residents are dying, under what circumstances and at what ages." At 26 of New York City's biggest and "most troubled" adult homes, 946 residents died between 1995 and 2001, 326 of whom were under the age of 60. When asked for records on the investigations of such deaths, state Health Department officials could provide only three files. The Times reports that state health officials acknowledge that they have failed to enforce a 1994 law that requires homes to report all residents' deaths. Both Gov. George Pataki (R) and New York state Health Commissioner Antonia Novello declined to comment, but Deputy Health Commissioner Robert Hinckley said the department would consider "ways to better investigate those deaths that are reported to us" and would issue a regulation informing the facilities that it would "strictly enforce the 1994 law on reporting deaths." Hinckley said, "We want facilities to follow the law, and we are redoubling our efforts to get them to report all deaths." As of Friday, "seven weeks after Hinckley's promise," no such regulation had been issued.

Background

Approximately 15,000 adults -- many of whom are low-income minorities -- with mental illness reside in more than 100 homes across the state. For three decades, state investigators have characterized the homes as "little more than psychiatric flophouses, with negligent supervision and incompetent distribution of crucial medication." While some of the facilities attempt to provide the best care possible, the Times reports that all of the homes statewide are plagued by the same "systemic problems," including unskilled workers and gaps in resident supervision. Most of the homes' operators have no mental health training and are "running commercial enterprises" where an empty bed "means no money," prompting some operators to hold residents in the facility instead of referring them to a hospital or to accept residents who are a threat to themselves or others, the Times reports (Levy, New York Times, 4/28).

Seaport Manor

In the second article in the series, the New York Times profiles the Brooklyn-based Seaport Manor, an adult home for the mentally ill that was called "The New Warehouse for the Insane" by a 1997 state Office of Mental Health report. The facility has inherited many of the former patients of Brooklyn's Kingsboro Psychiatric Center, one of the state's mental hospitals that closed in 1975 during the "deinstitutionalization" of the system. The "troubled psychiatric hospital was emptied and effectively recreated in a place even less equipped to deal with hundreds of seriously ill people," the Times reports. Seaport does not provide psychiatric services itself but is supposed to make sure that its residents receive needed care, either from an area clinic or from psychiatrists who visit the home. However, care instructions often go unheeded and prescriptions go unfilled at the home, the Times reports. The wait to receive psychotropic medication can exceed 30 minutes, "so some residents do not even bother. The ones who do are lucky if they get the correct pills," the Times reports. One former medication-room supervisor said, "I knew jack-diddly about medication" and was only put in charge because of high turnover at the home.

Resembling a 'Coed Prison'

According to the Times, "If a coed prison for the mentally ill were to exist, the inner workings of its yard might resemble Seaport. Except the prison would have security and a professional staff." The home's administrators declined requests to be interviewed, but their lawyer said in a recent state health department disciplinary hearing that "Seaport doesn't take the violations or alleged violations lightly." The health department said that it had not taken "more aggressive action," such as closing the facility, because the department would rather help "troubled homes improve conditions." Hinckley said, "Closure of a facility is disruptive to patients and residents, especially the elderly or mentally ill, and is typically pursued as a last resort after a home's repeated failures to comply with state regulations" (Levy, New York Times, 4/29).

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